Unique calling

The current state of the osteopathic profession: An in-depth discussion with two veteran DOs

Brian Loveless, DO, sits down with two physician leaders at different points in their careers to chat about the present and future of osteopathic medicine.

Editor’s note: The views expressed in this article are those of Dr. Thacker and Dr. Wolff and do not necessarily represent the views of The DO or the AOA.

In honor of having celebrated National Doctors Day on March 30, and NOM Week coming up on April 17-23, I wanted to take some time to reflect on the state of our profession. I have shared my own thoughts in past columns throughout the year, so instead I wanted to get a read on how some other physicians see the present and future of osteopathic medicine. I sat down (virtually) with two leaders in the osteopathic profession who are at different points in their medical careers: Richard Thacker, DO, and Sarah Wolff, DO.

Dr. Thacker is a graduate of the Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine. After completing an internal medicine residency in Pennsylvania, he became additionally certified in hospice and palliative care. He has practiced full-spectrum osteopathic internal medicine as well as hospice care for more than 20 years and currently serves as the Associate Dean of Clinical Resources at the Alabama College of Osteopathic Medicine. He is a member of the AOA Board of Trustees and Treasurer for the Osteopathic Political Action Committee.

Dr. Wolff is a graduate of Western University of Health Sciences College of Osteopathic Medicine of the Pacific. She completed a family medicine residency in Washington state and has practiced osteopathic family medicine for six years. She is currently the Director of Clinical Curriculum at Western University of Health Sciences College of Osteopathic Medicine of the Pacific-Northwest in Lebanon, Oregon. She has served as the AOA BOT Resident Trustee, as well as a member of the AOA Bureau of Emerging Leaders.

This was a great hour-long conversation with two outstanding osteopathic physicians. What follows is part one of an edited transcript of the discussion.

The first question is the usual one, but I want to spin it a little bit. Why osteopathic medicine, but more specifically, what attracted you to the profession?

Richard Thacker, DO

Dr. Thacker: I was born and raised in Michigan, a big osteopathic state. But I spent my teenage years and beyond in Florida, where my primary care physician was a DO. He was a general surgeon who practiced primary care. That was my first known exposure to the osteopathic medical profession.

I attended the University of Florida and wanted to go to medical school, but I was a married psychology student at the time. The osteopathic profession recognized that I was a nontraditional student and appreciated my maturity, interpersonal skills and desire to practice primary care. Though I was born in the Detroit metropolitan area, I spent many formative years in a rural area of north Florida, so Nova Southeastern accepted me very quickly. I was ecstatic and so appreciative.

I’ve tried to give back to the osteopathic profession ever since because the profession has given me so much and saw something in me that other schools did not.

Was there something in particular that drew you to osteopathic medicine or was it just that in that time, in that era, it provided an avenue toward practicing medicine?

Dr. Thacker: Yeah, I think it was my avenue. I’m a first-generation college graduate. I applied to both MD and DO schools, but Nova Southeastern recognized something in me and accepted me. That was it. I didn’t even keep looking. That’s when I knew, “This is home for me. This is a real fit for me,” and I was not disappointed. I was so enthusiastic that I became the freshman class president and then SOMA president the next year. It was just a natural progression for me to stay involved and I’ve tried to continue that through my professional career.

That’s great. Dr. Wolff, same question to you.

Dr. Wolff: I thought I wanted to be a dancer, and then I got too tall. Like all ballerinas, you hit 5’5” and you’re out. So I had to figure out something else to do. Though I was still young, I decided I wanted to become a doctor. I’m kind of headstrong about reaching my goals, so I set out to do everything I could to get accepted to medical school. I got involved, took all the pre-med classes that I could in undergrad and ended up teaching in some of the labs at the University of Oregon. During this time, I fell in love with teaching. I thought, “Oh goodness, I’ve dedicated my whole life to being a doctor, and here I am in the wrong field. I’m going to be a teacher.”

Sarah Wolff, DO

I had signed up for this wonderful trip to go do “doctor-y” things in Africa. I’d already paid for it, and beyond that, I wasn’t going to walk away from a trip to Africa. I traveled with a group to Tanzania, where we educated members of the Masai tribe on digging holes, washing hands and vaccination. If we encountered someone we thought could benefit from medical treatment, we would give them a red ticket so they could visit our clinic that was staffed with local doctors and other doctors from the U.S.

I remember talking to a mom through a translator, telling her we were going to prescribe her son a medication to treat his malaria. To my surprise, the mom refused. I’m sure I looked like a deer caught in headlights. She proceeded to tell me that she had met Western medicine before, yet her son was still sick on his deathbed, so it clearly must not work.

In that moment, I realized that no one had ever explained to her how malaria is transmitted, treated and prevented. I was doing patients and their families a great disservice by dispensing medication without taking the time to provide education. This was the turning point when I realized I wanted to pursue a career in medicine.

I got back to the States and wrote a beautiful essay with a lot of help from creative writers, describing my desire to combine teaching with medicine and use my hands to make a difference in people’s lives. I asked a friend’s father, who is an MD and a program director, to read the essay and give me his honest opinion. His response was, “You’re applying to the wrong schools. You clearly want to be a DO, so why are you applying to MD schools?”

I did not even know what a DO was at the time. After doing some research, I realized, “He’s right!” and then I started applying to DO schools. I always joke that an MD brought me to osteopathic medicine, but it’s really true. He could tell from reading my essay that I was looking to make a difference in medicine and being an osteopathic physician was that difference.

Do you think the attributes that attracted you to osteopathic medicine still exist in the profession today? Would they be a draw for current students?

Dr. Thacker: I do think that we’ve been seduced a bit by numbers and data. Those have value, but we’re so much more than our individual parts. We’re more than the MCAT score and the GPA. Certainly, MCAT scores can help predict a student’s ability to take standardized tests, but I worry that we’re placing too much emphasis on these factors and not enough on the value of a student’s life experiences.

The rigors of medical school are intense; in fact, it’s harder than ever to succeed. There’s more to learn and less time to learn it. We can’t lose sight that osteopathic principles and practice (OPP) is a major component, and so you have to make more room for immunology and pharmacology. But you don’t take that away from OPP or anatomy and musculoskeletal medicine. That’s not going to help us maintain the distinctiveness of osteopathic training and practice.

Also, our training of students has been solidly based on community training in hospitals. Do we want some exposure to tertiary care facilities and university-based programs? Sure, but community-based training works, and our profession is known for our expertise in that area. I want us to appreciate all aspects of training and all backgrounds, but I don’t want to get too far from what got us here.

All of our students don’t have to go into primary care, but the number grows a little bit smaller each year and most of the internists I know are either sub-specializing or becoming hospitalists. I’m an internist, but I practice traditional medicine. My type is becoming extinct, and students joke, “Oh, you’re a dinosaur. Nobody’s doing that anymore.” And it’s true, there are not many of us around. I’ve watched these trends develop, and I think that the gravity of everything else in the world is pulling us away from our nucleus.

Pursuing a career in medicine has got to be a calling. I think the world has changed a little bit. In the past, if you were a smart kid, you went to medical school. Now, there are tons of smart students, and that doesn’t mean they’re going to medical school. Will you make a lot more money somewhere else? Yeah, and you could sacrifice less, maybe not have the same demands. But if you have the calling, then I think this profession still offers fulfillment.

Dr. Wolff, same question to you. Do you think the profession still has the same draw that attracted you?

Dr. Wolff: Yes, but I think it’s important to realize that while we may have created that draw, we don’t own it anymore. Many of our colleagues, be it MD or PA or NP, are now adopting some of the qualities that initially made our profession unique, like providing empathetic care and looking beyond lab results.

I think the attraction is there, but we still have to work on owning it. Our profession is made up of such a unique mix of physicians with diverse backgrounds who offer patients a wealth of knowledge and experience. The rest of the world woke up one day and realized the osteopathic profession was doing things right, so now we have to push ourselves to refocus on the initial things that made us special.

Make sure you check back next month for part two of Dr. Loveless’s conversation with Dr. Wolff and Dr. Thacker.

Related reading:

Thoughts on defending the osteopathic medical profession

The DO Day experience: Why advocacy means so much as a physician


  1. Steven kamajian

    Thank you for this excellent interview! Health care is as always an evolving science,a strange business and sophisticated art. We choose the osteopathic profession knowing there was a subtle difference in opportunity in the interpretation of at least two of these fields when we were given an expanded differential diagnosis and expanded treatment options with our additional education. In order for us to take advantage of the opportunity given to us by our distinctive osteopathic education we must be meticulously thorough in taking a patient’s history and doing a complete examination. No one can be wholistic doing chief complaint only patient care. That isn’t distinctive nor does it require any additional skills than those of a NP or PA. Our path forward as a caring profession must be wholistic competency. No one can treat the body as a whole without the sophisticated act of taking a full patient history and doing a full physical. This is the door our students must walk through to stay on the separate and distinct road that our profession offers

  2. Robert S. Juhasz, DO, MACOI, FACP

    Very appreciative of the article and Dr. Thacker and Dr. Woolf’s comments. The ‘medical world’ has a tendency to norm and form to create a standard of care and treatment. That being said, the osteopathic profession was one of the nation’s original “health care reforms”. It remains critical for us to continue to teach the importance of getting to know the patient through thorough history and physical examination and care for them in mind, body and spirit. Although it has become increasingly more difficult for clinicians to do this, it is critical that our students and residents, MD’s and DO’s, are able to see us model these behaviors. It is also to study the impact of that care in improving care, quality and access while decreasing costs. Continuing to embed these attributes in our training programs is critical to showing the difference that our care can make, but it must be studied, discussed in professional venues inside the profession, but more importantly, in the larger world of medicine through publication and communication with our peers and the public.

    1. Steven Kamajian

      This 1000% accurate. We have an interesting process changing our profession as the EMR’s supplant individualization of the clinical process. If it isn’t in the drop down menu, it does not exist.
      I am reminded of an old mantra that leadership changes the future by creating the future. The EMR’s have changed the future and are now controlling all aspects of cognitive clinical participation. If that be our destiny, we will be replaced by AI
      and at some point we will become “proceduralists” not “cognitivists”. So as we reshape and recreate our osteopathic community, we need to remember our oldest of mantra’s that we
      and we alone create our communities. We can not think as a profession in singular pronouns….we can only think as “we”…yes many “we” subsets…but none the less we.
      Asking “what can we do” creates participation. Participation creates ownership. Ownership creates communities. Bravo for opening this up to
      “we”. Bravo for asking the questions that creates participation. Bravo for taking that participation to ownership and thus to
      the creation of our future osteopathic communities. That is leadership!

  3. Jay. Bayer. DO

    I was first DO on Harrisburg hospital staff as ER Dr in 1971. Quite a challenge but I broke the MD DO barriers. Was director for a time but was demoted as couldn’t have DO in charge of department as we trained all MD residents and interns. But I was finally accepted as peer after 4 yrs

  4. John C Baumann DO Facos

    Enjoyed the article I was in the first class of MSUCOM 1973 18 graduates my internship and surgical residency was at Detroit Osteopathic Hospital and Bicounty Community Hospital practiced Trenton Michigan until 2 years ago Trained residents interns medical students starting 1978 Osteopathy came into my life in 1953 with Dr Walker in Royal Oak Michigan I have newspaper articles of the start of our now profession and we should all pay more respect to the people who put our profession on the map especially Dr Myron Magen my cell is 734 693 1805 email baumann3231@yahoo.com thks

  5. Rich Thacker DO MACOI

    THANK YOU! Everyone For the additional insights and positive feedback. We hope in part 2 of this interview to touch on some of your comments and further the discussion about the future of our great profession.

  6. Robert C Smith

    The community of Tallahassee lost its best general practitioner when Dr. Thacker retired from his practice to teach at the Alabama College of Osteopathic Medicine in Dothan. He was a jewel to have as your doctor, he listened but when he put his glasses on top his head you had better listen real good because he was about to explain an issue or detail about something to you in your own conversation style, not doctor speak. He excelled in his way of communicating with his patients. He truly cared. You did not have to worry about being hospitalized and never seeing him, he made rounds and you always saw him. I am confident that he is training the doctors of the future to have the same compassion, knowledge, skills and abilities he possesses.

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